How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $104.71 | Professional | None | $85.11 | $85.11 | $104.71 |
BCBS South Carolina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $147.91 | Professional | None | $117.49 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $223.87 Typical High $309.03 | Facility | None | $144.54 | $223.87 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medcost Setting Facility Modifier None Typical Low $85.11 Median $102.33 Typical High $131.83 | Facility | None | $85.11 | $102.33 | $131.83 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $537.03 | Professional | None | $354.81 | $354.81 | $537.03 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $245.47 | Professional | None | $120.23 | $169.82 | $245.47 |
United Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | None | $107.15 | $125.89 | $125.89 |
9 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $42.66 Typical High $51.29 | Professional | 52 · Reduced service | $42.66 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $20.89 | Professional | 53 · Discontinued | $16.98 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $15.49 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $10.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $177.83 Median $177.83 Typical High $371.54 | Professional | 51 · Multiple procedures | $177.83 | $177.83 | $371.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $70.79 Typical High $147.91 | Professional | 80 · Assistant surgeon | $70.79 | $70.79 | $147.91 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $50.12 Median $50.12 Typical High $104.71 | Professional | 81 · Minimal assistant surgeon | $50.12 | $50.12 | $104.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $50.12 Median $50.12 Typical High $104.71 | Professional | 82 · Assistant surgeon, no resident | $50.12 | $50.12 | $104.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $50.12 Typical High $104.71 | Professional | AS · PA/NP assist | $50.12 | $50.12 | $104.71 |
Where South Carolina sits
The same service costs 26.9 times more in Kansas than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
South Carolina· 37th of 51
$126
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.